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What Causes Chronic Lung Pathology And Chronic Gastritis?

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Posted on Mon, 2 Jun 2014
Question: Hello Doctor,

I have been suffering from an unknown abdominal and chest pain for many years now - I have seen many doctors and to date I have spent over $160,000 trying to solve the problem, it is progressively worsening to dangerous levels.
As No Doctor has been able to work it out I started doing my own research which led me to a pancreatic possibility.

My Symptoms are
1/ Inflammation in the entire body - possibly systemic
2/ Heamoptasis (spelling) - blood on pillow in mornings
3/ GERD - Have had a Nissen Fundiplication which I am pretty sure went wrong - 3hr op and my heart stopped maybe it damaged the pancreas
4/ Left Upper Quadrant pain
5/ Popping sound/feeling and then the sound of fluid moving from one chamber to another
6/ Swallowing Motility Failures on Studies
7/ LOWERING 02 Saturation (Prime problem) - getting worse every month, down to 90 now
8/ Arterial Blood Gas studies that show very low O2 and especially P02 = 32 - DE-saturation only happens at rest - I am fine on excercise stress tests
9/ Immuno Deficiency and Lung Infections
10/ Sqaumous metaplasia in the bottom of lungs - scans suggest local inflamation in bottom of airways- no Lung Pathology to support it
11/ Yellow stool - but this may be from Plaquinal
12/ Feeling of Fullness in the stomach - like I have just been punched there
13/ Gas with very odd burps
14/ Enlarged Spleen
15/ High Uric acid (could the kidneys be compensating)
16/ Nuetrophillia - without infections
17/ High Triglycerides
18/ Abnormal LDH
19/ Abnormal (only recent) blood sugar
20/ Abnormal Albumin
21/ Dehydration found on blood tests
22/ Small signs of lower lung colapse without a reason
23/ Alectasis (spelling)
24/ Dark and smelly urine
25/ Increased and unstable heart rate
26/ Joint pain (more likely Psoriatic Arthritus)
27/ Clunking feeling in chest when breathing deep - like fluid is around the Diagphragm

I have not had any dramatic weight loss - in fact I find it hard to lose weight, even though i am very active and play indoor football 3 times a week.

I have had the following meds in the past that may affect the pancreas;
1/ Methotrexate (used for Psoriatic Arthritus) - Chemotherapy family of drugs
2/ Prednisone - on and off for last 8 years
3/ Statin Drugs for high Cholesterol - Tryglicerides
4/ Anti Retroviral Prophylactic drug (I was exposed to a girl who had HIV - took 3 week course) I am not XXXXXXX or a Drug User and I do not have HIV
5/ Immunoglubulan replacement therapy for Immunodeficiency IgG 1 and IgG 3
6/ Nexium
7/ Allopurinol

My O2 saturation in my arteries and lack of PO2 pressure is the prime concern here - it seems to only happen at rest - which is the opposite of cardiac and pulmonary complications - however with the constant abdominal ache I wonder if when i am at rest my subconscious takes over and perhaps I shallow breathe - My ABG's are quite severe and now I sleep with O2 - they will soon put me on O2 permenantly, I have lost everything and finding the solution on my own is the only choice as Doctors will not listen.

I have recenty had an MRI abdo/chest, looking at the acruate ligament in case my arterial supply was being cut off - they noted nothing special on the pancreas, I have had liver MRI's which are unremarkable - other than Fatty Liver - My Bronchoscopy's always find inflammation and sometimes blood and Gastroscopies just finds chronic stomach inflammation Gastritis (spelling).

I may be clutching at straws trying to find the answer, but can you tell me if a normal looking Pancreas could still have problems - as I believe some (a lot) of my symptoms above describe Pancreatitis / Pancreatic Cancer - My Liver has no Cirrhosis (fibroscan) - I am considering getting blood tests for the digestive enzymes etc - But I have heard these are not accurate, and I want to ensure that if I go for an ultrasound I am looking at the right things, Ie ducts vs organ etc.

I hope this all makes sense

PLEASE LET ME KNOW YOUR THOUGHTS

Kindest Possible Regards,

XXXX
doctor
Answered by Dr. Ashish Verma (1 hour later)
Brief Answer:
looks like multiorgan involvement...

Detailed Answer:
Hi XXXXXXX

As per your symptoms and investigation results and drug history, you seem to be having chronic lung pathology and chronic gastritis. And the culprit behind it is your prolonged intake of steroids (prednisolone). These steroids are known to suppress the body's immune mechanism leading to multi organ failure. There sure is infection as evident from your neutrophillia, systemic inflammation and squamous metaplasia in the lungs.

Scan's don't indicate pancreas involvement, however the possibility that they are involved as part of multi organ involvement cannot be ruled out. You should discuss about it with your treating doctor and plan further investigations.

Until then I would suggest that you stop the pill intake till you recover from all these. You might need to start on a broad spectrum antibiotics in consultation of a pulmonologist. And also get yourself tested for tubersulosis as it is known to infect in immunocompromised patients. And you symptoms can be attributed to it.

Your gastritis is mostly drug induced and you need to take your nexium twice a day along with a gastroprotector like sucralfate suspension.

Hope i have been helpful.

Regards
Dr. Ashish Verma
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Ashish Verma

General Surgeon

Practicing since :2008

Answered : 1290 Questions

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What Causes Chronic Lung Pathology And Chronic Gastritis?

Brief Answer: looks like multiorgan involvement... Detailed Answer: Hi XXXXXXX As per your symptoms and investigation results and drug history, you seem to be having chronic lung pathology and chronic gastritis. And the culprit behind it is your prolonged intake of steroids (prednisolone). These steroids are known to suppress the body's immune mechanism leading to multi organ failure. There sure is infection as evident from your neutrophillia, systemic inflammation and squamous metaplasia in the lungs. Scan's don't indicate pancreas involvement, however the possibility that they are involved as part of multi organ involvement cannot be ruled out. You should discuss about it with your treating doctor and plan further investigations. Until then I would suggest that you stop the pill intake till you recover from all these. You might need to start on a broad spectrum antibiotics in consultation of a pulmonologist. And also get yourself tested for tubersulosis as it is known to infect in immunocompromised patients. And you symptoms can be attributed to it. Your gastritis is mostly drug induced and you need to take your nexium twice a day along with a gastroprotector like sucralfate suspension. Hope i have been helpful. Regards Dr. Ashish Verma